Translation, cross-cultural adaptation and validation of the Italian version of the knee outcome survey - activities of daily living scale

Emanuele Tortoli; Samuele Passigli; Angelo Scrimitore; Andrea Raschi; Alessia Depalma; Giuseppe Giovannico; Leonardo Pellicciari

doi:10.1016/j.msksp.2023.102716

Translation, cross-cultural adaptation and validation of the Italian version of the knee outcome survey - activities of daily living scale

Musculoskelet Sci Pract. 2023 Feb:63:102716. doi: 10.1016/j.msksp.2023.102716. Epub 2023 Jan 3.

Authors

Emanuele Tortoli¹, Samuele Passigli², Angelo Scrimitore¹, Andrea Raschi³, Alessia Depalma⁴, Giuseppe Giovannico⁵, Leonardo Pellicciari⁶

Affiliations

¹ Department of Medicine and Health Science "Vincenzo Tiberio", University of Molise, Campobasso, Italy; FisioBrain, Arezzo, Italy.
² FisioBrain, Arezzo, Italy; University of Rome "Tor Vergata", Rome, Italy.
³ FisioBrain, Arezzo, Italy; Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health Campus of Savona, University of Genova, Genova, Italy.
⁴ ASL Bari, Bari, Italy.
⁵ Department of Medicine and Health Science "Vincenzo Tiberio", University of Molise, Campobasso, Italy.
⁶ IRCCS Istituto delle Scienze Neurologiche di Bologna, Bologna, Italy. Electronic address: leonardo.pellicciari@gmail.com.

PMID: 36630780
DOI: 10.1016/j.msksp.2023.102716

Abstract

Purpose: The Knee Outcome Survey - Activities of Daily Living Scale (KOS-ADLS) is a joint-specific questionnaire measuring symptoms and functional limitations experienced by individuals with painful knee disorders. The original version of the KOS-ADLS has been shown to be reliable, valid and responsive to change. The purpose of this study was to perform a translation and cross-cultural adaptation of the KOS-ADLS into Italian and to assess its reliability and validity.

Methods: In accordance with standard procedures, the original version of the KOS-ADLS was translated and cross-culturally adapted into Italian (KOS-ADLS-I). Then, the KOS-ADLS-I was administered to 150 patients with knee disorders. A subsample of patients compiled the KOS-ADLS-I again after five/seven days later to evaluate test-retest reliability. Symptoms and function-oriented questionnaires were also completed to evaluate construct validity. Structural validity (Explanatory Factor Analysis [EFA]), internal consistency (Cronbach's alpha), test-retest reliability (Intraclass Correlation Coefficient [ICC]), measurement error (Standard Error of the Measurement [SEM], Minimal Detectable Change [MDC]), and construct validity (hypothesis testing) were assessed.

Results: The cross-cultural adaptation procedure revealed no major problems. EFA revealed a unidimensional structure. Internal consistency was high (Cronbach's alpha = 0.976) and the test-retest reliability was excellent (ICC = 0.990, 95%CI: 0.980-0.995) with low measurement error (SEM = 2.6 points; MDC = 7.1 points). The construct validity resulted to be satisfactory, as 100% a-priori hypothesis were met.

Conclusions: The KOS-ADLS-I is a reliable and valid questionnaire for the assessment of symptoms and functional limitations in individuals with musculoskeletal knee disorders and it can be used in clinical practice and research.

Keywords: Health status; KOS-ADL; Knee; Outcome measure; Psychometrics; Questionnaires.

MeSH terms

Activities of Daily Living*
Cross-Cultural Comparison*
Humans
Knee Joint
Reproducibility of Results
Surveys and Questionnaires